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Risk of colorectal cancer for fecal immunochemistry test‐positive, average‐risk patients after a colonoscopy
Author(s) -
Kawamura Takuji,
Nakamura Shiho,
Sone Daiki,
Sakai Hiroaki,
Amamiya Kana,
Inoue Naonori,
Sakiyama Naokuni,
Shirakawa Atsushi,
Okada Yusuke,
Sanada Kasumi,
Nakase Kojiro,
Mandai Koichiro,
Suzuki Azumi,
Morita Atsuhiro,
Tanaka Kiyohito,
Uno Koji,
Yasuda Kenjiro
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14517
Subject(s) - colonoscopy , medicine , colorectal cancer , odds ratio , gastroenterology , confidence interval , logistic regression , cancer
Background and Aim Because the risk of colorectal cancer has not been well examined in fecal immunochemistry test (FIT)‐positive patients who previously underwent colonoscopy, this study aimed to investigate this topic. Methods This was a single‐center, observational study of prospectively collected data in Japan. FIT‐positive, average‐risk patients who underwent colonoscopy were divided into groups as follows: those who never underwent colonoscopy in the past (no colonoscopy group), those with a history of colonoscopy between 6 months and 5 years (0.5‐ to 5‐year colonoscopy group), and those with a history of colonoscopy more than 5 years ago (> 5‐year colonoscopy group). We investigated the prevalence of advanced neoplasia and invasive cancer among these groups using multiple logistic regression analysis. Results Detection rates of advanced neoplasia in the no colonoscopy group, 0.5‐ to 5‐year colonoscopy group, and > 5‐year colonoscopy group were 14.8% (240/1626), 3.9% (13/330), and 6.9% (17/248), respectively. Detection rates of invasive cancer in each aforementioned group were 5.7% (92/1,626), 0.3% (1/330), and 1.2% (3/248), respectively. Odds ratios of advanced neoplasia in the 0.5‐ to 5‐year colonoscopy group and > 5‐year colonoscopy were 0.23 (95% confidence interval [CI]: 0.13–0.42) and 0.40 (95% CI: 0.24–0.68), respectively, in multivariate analysis. The odds ratios of invasive cancer in each aforementioned group were 0.05 (95% CI: 0.01–0.37) and 0.19 (95% CI: 0.06–0.61), respectively. Conclusion Re‐screening with the FIT should not be recommended for at least 5 years for average‐risk patients after colonoscopy without high‐risk neoplasms, because the risks of colorectal cancer are low in such patients.